Management of medical equipment - Essay Example

?Management of Medical Equipment Introduction Medical equipment is an important tool for medical practitioners. It allows them to function efficiently in hospitals and clinics in order to ensure the management of patient conditions. Managing such equipment is a crucial part of efficient health care services delivery especially as the delivery of other traditional health services may sometimes be delayed. Failure of management of medical equipment can reduce the efficacy of care and can also endanger the life of the patients. For as long as medical equipment is well maintained, faster and more efficient medical interventions can be provided by the medical professionals. This paper will discuss the management of medical equipment. It will first describe the phases of the repairable medical equipment lifecycle based on the user’s perspective, including the two- sub-cycles: acquisition sub-cycle and the utilization subcycle. Highlighting the utilization sub-cycle, this essay shall also describe how the phases link together in order to ensure the reduction of overall clinical risk. This essay will explain how this cycle fits into the clinical governance framework. This essay is being carried out in order to help this student gain an improved understanding of the management of medical equipment and the means by which their use can be extended. Body Phases of repairable medical equipment lifecycle Based on the user’s perspective, medical equipment usage goes through various phases. The initial phase is the planning and acquisition phase, which mostly includes the acceptance process within the clinical setting (Chan, 2003). Once the equipment has reached the end of its useful life, it is to be discarded and replaced. The process of acquisition, acceptance, and the replacement of the equipment occurs only once within the life of the medical equipment; nevertheless the use of technology includes various activities which can be carried out numerous times (Chan, 2003). The medical equipment lifecycle can therefore be broken down into two subcycles including the acquisition and the utilization subcycles (Chan, 2003). These two subcycles include various activities and elements which are meant to ensure the efficient workings of medical resources, technologies, and equipment (Bowles, 2008). The acquisition subcycle is further subdivided into the following phases: technology assessment, technology planning, acquisition, acceptance, and finally replacement and disposal (Chan, 2003). Technology assessment includes the assessment of the technology or in this case the equipment, mostly in relation to its safety and performance, as well as its projected effect in terms of patient outcomes and its impact on the economic and ethical elements of healthcare (Vallejo-Torres, et.al., 2008). Medical technology and equipment are evaluated in general terms and in relation to other technologies, procedures and interventions. The goal of medical technology assessment is to ensure objective as well as quality data which can be used by stakeholders in their decision-making (Vallejo-Torres, et.al., 2008). The general application of the technology assessment is on the assessment of technologies and equipment after they are introduced in the marketplace. Other experts and researchers however are also quick to point out that new technologies must be assessed before they are incorporated into the clinical practice (Pietzsch and Pate-Cornell, 2008). By evaluating the technology and equipment in the soonest possible time, it is possible to improve health outcomes, reduce wrong investments, and prevent possible ethical issues arising from these technologies (Pietzsch and Pate-Cornell, 2008). Technology planning is the next phase in the acquisition subcycle (Dyro, 2004). This planning phase includes an interdisciplinary planning process alongside years of experience in hospital management and construction, ensuring the establishment of functional procedures within the clinical practice (Hospital Technology, 2012). Planning medical technology also includes the acquisition of large-scale medical equipment including MRI, CT, PET-CT, and angiographies among others (Hospital Technology, 2012). Planning the installation of ICUs, operating rooms, emergency centres, specialist clinics, as well as radiotherapy units are part of the acquisition process of medical technology. These elements require design planning, one which pictures the goals in relation to the resources of the clinic or hospital (Hospital Technology, 2012). The planning of the technology includes installation planning as well as project control. These are elements which have to be ironed out by the administrators before the equipment is actually acquired. The planning process would also include budgetary allocations for the equipment, as well as planning for its installation and use by competent and qualified medical staff (Hospital Technology, 2012). Once the details of the technology planning are ironed out, the acquisition of the equipment follows (Khandpur, 2004). The acquisition of the technology includes the actual purchase of the equipment itself. Acquisition involves the transfer of the technology from the medical company to the hospital or clinic (Bronzino, 2000). It would necessitate an administrative as well as a financial process in order to iron out its transfer and its subsequent use (Bronzino, 2000). Accepting its use would therefore include the testing of the equipment. Initially, the use of the technology would be considered test periods for the hospital as the qualified individuals may work with experts in order to acquire the proper skills to operate the equipment (Sandham, 2012). Acceptance checks are part of this phase as inspections are made on whether or not the equipment arrived intact. This acceptance testing includes the evaluations on documentation of the equipment, assessing the presence of user manuals with such manuals to be made available to the users of the equipment (Sandham, 2012). Technical evaluation of the equipment are also carried out in order to check whether the equipment is complete and the tools are undamaged (Sandham, 2012). Safety markings are part of the acceptance testing process. The last phase of the acquisition process is the replacement and disposal of the medical equipment. The disposal usually depends on the policy for the health facility involved (NHS, 2012). Mostly however, medical equipment is disposed of because it is found to be faulty, or if it is found to have failed safety standards, or if the equipment no longer serves a purpose to the facility (NHS, 2012). Policies on the possible reuse of the equipment are also usually based on the policies of the facility. As for the replacement of medical equipment, this is often carried out when the equipment is “worn out and beyond economical repair” (NHS, 2004, p. 1). Where equipment is damaged and can no longer be repaired without it costing too much, replacement is also essential. Unreliable equipment is also usually replaced. It is incumbent upon the equipment services manager to indicate which medical equipment falls in the criteria used in determining the need for replacement (NHS, 2004). Where medical equipment is deemed unserviceable, it is also the responsibility of equipment services managers to indicate to the concerned department managers about the need for equipment replacement. After the devices manager have approved the disposal or scrapping of the medical equipment, the equipment may then be disposed (Northrop, 2002). The Medicines & Healthcare Products Regulatory Agency (MHRA) makes recommendations on the cannibalisation of equipment which includes the removal of functional spare parts and using or installing these on similar functional machines (NHS, 2004). Utilisation subcycle The other phase in the medical equipment lifecycle is the utilisation subcycle. Training involves the process of instructing the handlers and the primary users of the equipment on the appropriate use and the management of the equipment (Webb, 2003). This would likely be carried out by the manufacturers of the equipment who are very much familiar with how the equipment would be used. This would include the process of training the personnel on the precautions they need to take, including the so-called dos and don’ts of the medical equipment (Chan, 2003). Maintenance of the equipment would also be part of the training process for the medical personnel (Bali and Dwivedi, 2007). Hospitals usually have technicians within their employ who are tasked with regularly checking the equipment, maintaining it, cleaning it, and managing its wear and tear (Rao and Guha, 2001). Maintenance is also managed in association with the manufacturers of the equipment, especially in the replacement of parts and the periodic quality assurance processes which have to be carried out on the equipment. Quality assurance is carried out in order to identify defective medical equipment (David, 2003). Hospitals and other medical facilities usually have quality assurance departments which can evaluate the equipment and maintain the quality of the work. The quality assurance process helps improve the quality of work and reduce the risks for injuries among staff members and patients (Rao and Guha, 2001). The last phase in the utilisation subcycle is the risk management phase. This phase seeks to assist the hospital or clinic in reducing the possibility of equipment-related injuries, reducing liabilities for mishaps, and to comply with standard reporting requirements (Villafane, 2009). The rating system is usually applied for most equipment. Such rating system may indicate defibrillators to be high risk and otoscopes to be low risk (Chan, 2003). These ratings are meant to guide the users and the quality assurance technicians in their assessment of the medical equipment. Utilisation subcycle and clinical governance The various phases in the utilisation subcycle work with each other, forming a strong and effective unit which can effectively reduce the risk to the staff and more importantly, the patient (Pardeshi, 2005). The utilisation subcycle begins with the training phase, where the users are equipped with the proper skills on the use and management of the medical equipment. Proper usage of the equipment is the end goal of the training process, especially as the use of the equipment is directly related to the efficient management of the patient’s condition (Wang, 2009). Where the users of the equipment are properly trained, the risk to the patient and the medical staff is reduced. Training is however not sufficient in order to reduce patient and user risk. The maintenance is very much a huge part of risk reduction. The training in equipment use would also include how the users can maintain the equipment, and this process usually includes the daily cleaning and maintenance of the equipment (Pardeshi, 2005). For more detailed and comprehensive maintenance, the assistance of technicians would often be needed and these technicians are also required to undergo training on the use of the equipment (Swansburg and Swansburg, 2002). Once the right people are equipped with the skills in the use and maintenance of the equipment, the quality assurance phase usually comes naturally (Pardeshi, 2005). This phase is very much dependent on the skills of the users as well as the maintenance processes which the users and the technicians observe in relation to the equipment. Quality assurance processes often involves routine maintenance and routine equipment check by the technicians as well as independent quality assurance agencies (WHO, 2013). These agencies have the responsibility of further evaluating the equipment as well as the skills of the users in order to determine how well the equipment is functioning (Cker and Ziefle, 2010). For as long as training, maintenance, and quality assurance is secured, patient and staff user risks are minimized and more importantly, eliminated. In relation to clinical governance, the phases of utilisation are important elements which can help ensure effective clinical governance (Starey, 2001). Clinical governance includes the following elements: education, clinical audit, clinical effectiveness, risk management, research and development, as well as openness. The training phase in the utilisation subcycle is very much associated with the education element of clinical governance, especially as the training phase would include the process of continuing education, updating the current knowledge of the medical staff with the end goal of ensuring the efficient delivery of health services (McSherry and Pearce, 2011). Training would also help support research and development, especially as training would often involve updates from evidence-based research (Bali and Dwivedi, 2007). Training is a continually updated process and the updates mostly come from the evidence yielded by research and development activities. Where new and more efficient ways of managing and using equipment are recommended based on research and recent developments, then these new ways can be introduced into the practice via training activities for staff (Chambers and Wakley, 2000). The clinical audit process is associated with quality assurance. Audit is also usually carried out by independent agencies who evaluate the skills and the resources of the clinical units (Starey, 2001). Quality assurance involves independent agencies who seek to assess the skills as well as the knowledge of the staff using and handling the equipment. These agencies are also there to assess the equipment itself. Clinical audit is an important addition to effective clinical governance as it helps minimize and eliminate the risks to staff users and patients (Gillies, 2000). In the end, the ultimate goal for both utilisation and clinical governance is on achieving clinical effectiveness and reducing patient and staff risks. Clinical effectiveness assesses the extent to which a specific intervention or remedy works (Swage, 2004). The assessment in general is a useful tool, and it is also supported by evaluating whether the intervention is applicable and it is economically efficient. The emerging evidence on any intervention is based on research and in the case of the use of equipment, the support from evidence-based practice indicates a favourable direction in ultimately achieving clinical efficiency and managing patient and staff risks (Starey, 2001). Conclusion Medical equipment management is an important aspect of the efficient delivery of healthcare services. The process of acquisition and utilisation involves phases which are eventually geared towards the efficient and safe use of medical equipment. These phases also include details which can help provide tools for the users and the administrators in the risk reduction for medical equipment. In relation to clinical governance, the application of the different phases of utilisation for medical equipment is an important tool which can also be used by administrators in order to provide clinical efficiency for the staff and achieve improved and safe patient outcomes. References Bali, R and Dwivedi, A., 2007. Health informatics: Healthcare knowledge management: issues, advances and successes. London: Springer. Bowles, R., 2008. Biomedical equipment technicians. New York: Tstc Publishing. Bronzino, J., 2000. The biomedical engineering handbook. London: Springer. Chambers, R. and Wakley, G., 2000. Making clinical governance work for you. London: Radcliffe Publishing. Chan, A., 2003. Medical technology management practice. New York: Charles C Thomas Publisher. Cker, C. and Ziefle, M., 2010. Smart healthcare applications and services: developments and practices. London: IGI Global. David, Y., 2003. Clinical engineering. California: CRC Press, Inc. Dyro, J., 2004. The clinical engineering handbook. New York: Academic Press. Gillies, A., 2000. Excel for clinical governance. London: Radcliffe Publishing. Hospital Technology, 2012. Design planning [online]. Available at: http://www.hospitaltechnologie.com/services/design-planning [Accessed 11 January 2013]. Khandpur, R., 2004. Biomedical instrumentation: Technology and applications. UK: McGraw-Hill Companies, Inc. McSherry, R. and Pearce, P., 2011. Clinical governance: A guide to implementation for healthcare professionals. London: John Wiley & Sons. Northrop, R., 2002. Noninvasive instrumentation and measurement in medical diagnosis. California: CRC Press, Inc. NHS, 2004. Policy on the replacement of medical devices /equipment [online]. Available at: http://www.dwmh.nhs.uk/sections/publications/documents/FOI24745202036.pdf [Accessed 11 January 2013]. NHS, 2011. Medical equipment disposal policy [online]. Available at: http://www.tamesidehospital.nhs.uk/documents/medicalequipmentdisposalpolicy.pdf [Accessed 10 January 2013]. Pardeshi, G., 2005. Medical equipment in government health facilities: missed opportunities. Indian J Med Sci., 59(1), pp. 13-9. Pietzsch, J., and Pate-Cornell, M., 2008. Early technology assessment of new medical devices. International Journal of Technology Assessment in Health Care, 24(1), pp. 36–44. Rao, C. and Guha, S., 2001. Principles of medical electronics & biomedical instruments. New York: Universities Press. Sandham, J., 2012. Acceptance testing of medical equipment [online]. Available at: http://www.ebme.co.uk/arts/accept/ [Accessed 11 January 2013]. Starey, N., 2001. What is clinical governance?. Evidence-based Medicine, 1(12), pp. 1-8 Swage, T., 2004. Clinical governance in healthcare practice. London: Elsevier Health Sciences. Swansburg, R. and Swansburg, R., 2002. Introduction to management and leadership for nurse managers. London: Jones & Bartlett Learning. Vallejo-Torres, L., Steuten, L., Buxton, M., et.al., 2008. Integrating health economics modeling in the product development cycle of medical devices: a Bayesian approach. International Journal of Technology Assessment in Health Care, 24(4), pp. 459–64. Villafane, C., 2009. Biomed: From the student's perspective. New York: Technicians Friend.com. Wang, B., 2009. Strategic health technology incorporation. London: Morgan & Claypool Publishers, Nov 1, 2009 Webb, A., 2002. Introduction to biomedical imaging. London: John Wiley & Sons. World Health Organization, 2013. Life-cycle of medical equipment [online]. Available at: http://www.euro.who.int/en/what-we-do/health-topics/Health-systems/health-technologies/life-cycle-of-medical-equipment [Accessed 12 January 2013]. Read More